title: First experience using 4-dimensional hysterosalpingo-contrast sonography with SonoVue for assessing fallopian tube patency.
abstract: This study was conducted to describe our first experience using transvaginal 4-dimensional (4D) hysterosalpingo-contrast sonography with SonoVue (Bracco International BV, Amsterdam, the Netherlands) for diagnosis of fallopian tube patency. The study was prospective and conducted in a university hospital setting. The sonographic procedures included 2-dimensional transvaginal sonography for evaluating uterine and ovarian mobility, observing intubation, and determining the initial plane and 4D hysterosalpingo-contrast sonography for observing periovarian and pelvic diffusion. Ninety-six outpatients visiting infertility clinics underwent 4D hysterosalpingo-contrast sonography. All patients finished the examination successfully. A total of 192 fallopian tubes were assessed, of which 95 (49.5%) were classified as type A (the tube was patent, and the contrast agent flowed smoothly through it), 72 (37.5%) as type B (the tube was patent, but the contrast agent did not flow smoothly inside it), and 25 (13.0%) as type C (blocked). Sixteen patients underwent laparoscopy or laparoscopy combined with hysteroscopy; 28 tubes (87.5%) were concordant with laparoscopy. The sensitivity, specificity, positive predictive value, negative predictive value, and Youden index for 4D hysterosalpingo-contrast sonography versus laparoscopy were 81.8%, 90.5%, 81.8%, 90.5%, and 0.72 respectively. In total, 92.7% of patients did not require a hospital stay after 4D hysterosalpingo-contrast sonography, and none need resuscitation. The others stayed in the hospital for clinical observation because of a severe vasovagal reaction or severe pain but received only bed rest without any medical treatment. Forty patients (41.7%) felt slight pain; 39 (40.6%) felt moderate pain; and 15 (15.6%) had a vasovagal reaction. No procedure or postprocedure complications occurred in any patient. In conclusion, 4D hysterosalpingo-contrast sonography with SonoVue is an available screening method for assessment of tubal patency and is tolerable for most patients.
authors.affiliation: Department of Ultrasonography, Third Affiliated Hospital of Southern Medical University, 183 W Zhongshan Ave, 510630 Guangzhou, Guangdong, China.
authors.forename: Yanni
authors.initials: Y
authors.lastname: He
authors.forename: Qiang
authors.initials: Q
authors.lastname: Geng
authors.forename: Hongmei
authors.initials: H
authors.lastname: Liu
authors.forename: Xiaohua
authors.initials: X
authors.lastname: Han
mesh_terms: D000328:Adult; D000465:Algorithms; D015984:Causality; D002681:China / Q000453:epidemiology; D015897:Comorbidity; D003287:Contrast Media; D005184:Fallopian Tube Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D005186:Fallopian Tube Patency Tests / Q000706:statistics & numerical data*; D005187:Fallopian Tubes / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D007247:Infertility, Female / Q000000981:diagnostic imaging*; D010743:Phospholipids; D010865:Pilot Projects; D015995:Prevalence; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013459:Sulfur Hexafluoride; D014463:Ultrasonography; D055815:Young Adult
chemical_list: D003287:Contrast Media; D010743:Phospholipids; C420843:contrast agent BR1; D013459:Sulfur Hexafluoride
keywords: 4-dimensional; hysterosalpingo-contrast sonography; laparoscopy SonoVue; tubal patency